Active NPI
Patricia Ann Hickman, CRNA
- General Acute Care Hospital
- Clarksburg, WV
National Provider Identifier
1295843209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 043485
- Practice address
- RR 5 Box 635
Clarksburg, WV 26301-9333 - Phone
- (304) 745-3004
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 043485 | WV | Primary |
Addresses
Primary practice location
RR 5 Box 635
Clarksburg, WV 26301-9333
Mailing address
RR 5 Box 635
Clarksburg, WV 26301-9333
Phone (304) 745-3004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 554 | WV | MD | Sports Physician Chiropractor |
| 043485 | WV | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295843209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 5 BOX 635",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263019333",
"telephone_number": "304-745-3004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 5 BOX 635",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263019333",
"telephone_number": "304-745-3004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "PATRICIA",
"middle_name": "ANN",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "WV",
"license": "043485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.